As spine surgeons confront growing physician shortages and longer wait times, Lali Sekhon, MD, PhD, said the strain is already reshaping access to care in some communities. However, he sees potential for AI to address present and future gaps in spine care.
Dr. Sekhon, of Reno (Nev.) Orthopedic Center, said he’s already seeing the effects of physician shortages in his own work, following a pattern from family medicine.
“In our community, it’s very hard to get a family doctor,” Dr. Sekhon said. “If you called my office today for an appointment, my next available time is in March. “We have fewer spine surgeons now than when I first came to Reno in 2005. As they’ve retired or moved away, the replacement hasn’t happened to the speed that you want. In terms of family doctors, it’s a drought. When I came to this town, 90% of the letters I sent were to the physicians and now 95% are to nurse practitioners and PAs. The APPs are filling this void.”
But he’s optimistic about AI as a solution to these obstacles.
“I think AI is going to fill the next void,” he said. “What’s going to happen is the average person will sit at home, and they’ll have an AI doctor that will guide them for routine stuff. Access is going to become one of the bigger issues, and it’s variable in different communities, but here it has become a bigger issue than before.”
Dr. Sekhon likened AI’s boom to the early age of the internet, which empowered patients to gain more knowledge.
“I think we’re at the same cusp with AI, and as physicians it’s up to us to guide them,” he said. “I’m already getting patients who will come in and they say, ‘This is what ChatGPT said.’ As [AI] gets refined, it’s going to be useful in so many ways that we can’t think of.”
And for practices and hospitals, AI could create a new normal for surgeons when evaluating outcomes and costs.
“Whether we like it or not, it’s here, and the question is how do we use it, and how do we harness it?” he said. “In spine practices the practicality is going to be scheduling. It’s going to make that easier. Hospitals will probably use it to analyze the data on the efficiency of surgeons. Insurance companies obviously can use that data, and they probably already are, to look at 30-day readmission rates, cost per encounter and conversion rates … I see a future where, as a surgeon, there’s far more scrutiny on your outcomes and your cost delivery. That may be publicly available so that you can look up a surgeon’s data.”
For physicians, Dr. Sekhon emphasized the importance of taking a constructive approach to using AI. Future spine surgeons will also need to learn how to approach the knowledge doors that AI has to offer, he said.
“When I grew up, if you had access to encyclopedias, you were the [popular] kid,” he said. “Getting access to knowledge was challenging. My children’s generation has access to all the knowledge of the world, and what they’ve got to master is managing this volume of data. I think for the next generation of spine surgeons, it will be similar. They have access to all the data and all the studies. The hardest part is staying up to date, and so if you’re a neurosurgeon and you’re doing cranial surgery and trauma surgery and spine surgery how do you stay up to date with the latest treatments for conditions? What the physician is going to have to do is work with AI so it understands who they are, and then let AI curate what you need so that you have access to the information that you need.”
